A review of five years of data for colonoscopies from ten large Coronis Health clients indicates the basic trends of this part of the business. The majority of patients have commercial insurance, which pays well. Medicare patients represent about a third of all cases at discounted Medicate rates. Self-pay patients with no insurance are a very small piece of the overall pie.
As we recently reported, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Medicare Physician Fee Schedule. The volume of colonoscopies started to grow in 2020, just before the pandemic. But, once it ramped up, case volumes have remained quite consistent.
As is often the case, Medicare and Medicaid rates have a significant impact on the overall net yield per case. Payer mix is always determinative in the calculation of the profitability of the service. As indicated below, the overall average yield per case is approximately $260. Clearly, the efficiency of the venue and the average number of cases performed per day are the most critical factors in determining profitability. Given the short duration of colonoscopies, if scheduled effectively, the revenue generated per hour is high, which could make this a particularly profitable service line.
This review clearly demonstrates the potential value of endoscopy to the anesthesia practice. The thing to remember is that success in endoscopy is all about volume and efficiency of the clinic.